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State Auditors Find $36,676 in Medicaid Overpayments to Provider in Clark County

Thursday, April 6, 2017

Columbus – A Medicaid examination by Auditor of State Dave Yost’s office found a provider in Clark County was overpaid by $36,676 from 2012 through 2014.

Auditors reviewed 1,138 services provided by Emily E. Arnold, a registered nurse, and found she submitted 101 nursing services for reimbursement without first obtaining required authorization from a physician.

“A doctor has to vouch for every nursing service before a provider can bill the state,” Auditor Yost said. “A physician’s signature on a completed plan of care helps protect Ohio’s tax dollars from waste and ensures patients receive the right treatment.”

Documentation for four additional services listed start and end times that were identical to other services provided on the same date, meaning the four could not have occurred at the reported times. Also, the units billed for one other service exceeded the amount recorded on service documentation.

With interest, Arnold owes $38,937 to the Ohio Department of Medicaid. She was reimbursed a total of $230,999 for 2,333 services during the period.

The Auditor of State’s office, one of five independently elected statewide offices in Ohio, is responsible for auditing more than 5,900 state and local government agencies. Under the direction of Auditor Dave Yost, the office also provides financial services to local governments, investigates and prevents fraud in public agencies and promotes transparency in government.